The follow-up of asymptomatic persons with antibodies to pyruvate dehydrogenase in adult population samples

Abstract

A significant number of asymptomatic patients found to have antibodies to PDC are at high risk of developing primary biliary cirrhosis.

Increased prevalence of antimitochondrial antibodies in first-degree relatives of patients with primary biliary cirrhosis

“…17 Moreover, the detection of AMAs in an otherwise healthy individual without abnormal liver tests may indicate a risk for the future development of overt disease. 18,19 The major epitope of PDC-E2 recognized by AMAs overlaps with those of autoreactive B-and T-cells shown to specifically target the biliary epithelial cells lining the intrahepatic bile ducts of PBC patients. 17 The process by which self PDC-E2 moieties become antigenic in PBC has been widely studied, and several mechanisms, including molecular mimicry, self alteration by xenobiotics, and intact immunogenic epitopes released from apoptotic biliary epithelial cells, have been suggested.…”

Update on the epidemiology of primary biliary cirrhosis

“…Individuals who have AMA-positive titers and normal ALP levels do not meet standard criteria for PBC; however, Mitchison et al reported that, of 29 patients with high AMA titers and initially normal ALP levels on follow-up 18 years later, 83% had elevated ALP levels and 76% had symptoms of PBC [60]. Kisand et al similarly identified 14 patients with positive AMA-M2 titers, and of the eight who were followed, three had developed PBC by the ninth year [61].…”

The Predictive Significance of Autoantibodies in Organ-Specific Autoimmune Diseases

“…The group which initially had had either anti-thyroid antibodies or raised serum thyroid-stimulating hormone (TSH) was associated with a significantly raised risk of developing clinical hypothyroidism [1]. Having only a raised serum TSH (>6 mU/l) meant an odds ratio of 8 (95% confidence interval, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] for women and 44 (19-104) for men. Having positive anti-thyroid antibodies alone meant an odds ratio of 8 (5-15) for women and 25 (10-63) for men.…”

“…Kisand et al [10], in a screening study of the prevalence of autoimmune diseases in the Estonian population, tested 1,958 individuals aged between 15 and 99 years. They used two immuno-enzymatic (enzyme-linked immunosorbent assay) tests, one for antibodies to native pyruvate dehydrogenase complex (PDC) and the other to recombinant PDC-E2 fusion protein.…”